Coma

HISTORY_LIST
comatose
obtunded
stupor
coma
confusion
hallucinations
IV glucose response
clouded thinking
agitation
photophobia
onset
activity prior to onset
trauma
suicide attempts
depression
epilepsy
post ictal state
fever
vertigo
nausea
vomiting
chest pain
cough
INFECTIOUS DISEASES
meningitis
encephalitis
otits media
CHRONIC DISEASE 
dementia
stroke
TIA
hypertension
renal dz.
liver dz.
cardiac dz.
SURGERY 
neurosurgery
PREVIOUS TESTS
CT scan of head
EEG
TRAUMA OR INJURIES
head trauma
MVA's
SOCIAL HISTORY
smoking
alcohol
caffeine
illicit drugs - cocaine
ALLERGY
medications
foods
seasonal


MEDS_LAB_TESTS
**** MEDS
insulin
hypoglycemic
narcotics
antipsychotics
steroids
anticholinergics
cimetidine
anticoagulants
**** LAB
glucose
electrolytes
calcium
BUN
Cr
ABG
ammonia
blood alcohol level
LFT
urine toxicology screen
B12
folate
**** TESTS
EEG
MRI/CT of head


REVIEW_OF_SYSTEMS_1
GENERAL
weight changes
appetite changes
anorexia
difficulty sleeping
fever
chills
polyphagia
hypophagia
changes in thirst
sleeping habit change
bowel habit change
fatigue
hypertension
previous physical exams
SKIN
pigmentation changes
texture changes
lesions
eruptions
pruritis
easy bruising
easy bleeding
unusual hair loss
changes in hair distribution
skin masses
finger/toe nail change
rashes
hives
striae
skin atrophy
uremic frost
hirsutism
plethora
neurofibromatosis lesion
HEENT
head trauma
skull fractures
head masses
hearing loss
vertigo
chronic ear infection
ear discharge
ear pain
hearing aid use
loss of vision
recent change in vision
photophobia
diplopia (double vision)
glaucoma
exudates
dry eyes
eye pain
cataracts
eye surgery
itchy eyes
excessive tearing
corrective lenses
nose bleeds
chronic sinusitis
nasal fractures
nasal drainage
polyps
changes in sense of smell
edentulous (without teeth)
partial plate
full plate
recent dental work
oral lesions
tonsillitis
strep throat
tongue problems
voice changes
chronic hoarseness
chronic halitosis
NECK
neck masses
enlarged thyroid gland
brachial cleft cysts
neck injury

REVIEW_OF_SYSTEMS_2
CHEST
chronic coughing
sputum production
hemoptysis
wheezing
pneumonia
bronchitis
TB
TB exposure
SOB (altered by position?)
edema
chest pains
pacemaker
HEART
MI
coronary artery disease
heart murmur
heart valve disease
left ventricular hypertrophy
mistral valve stenosis
pericarditis
palpitations
DOE
paroxysmal nocturnal dyspnea
orthopnea
edema
hypertension
rheumatic fever
cardiomyopathy
ectopic heart beats
arrhythmia
exercise intolerance
claudication
heart medications
ABDOMEN
abdominal pain
nausea
vomiting
diarrhea
constipation
hematochezia
hematemesis
hemorrhoids
GI x-rays
GI scopings
rectal bleeding
ulcers
bowel polyps
bowel incontinence
gall bladder disease
gall stones
hepatitis
cirrhosis
hepatomegaly
splenomegaly
GU
renal insufficiency
renal failure
dialysis
kidney stones
kidney disease
kidney cyst
flank pain
hematuria
pyuria
dysuria
chronic cystitis
nocturia
anuria
hesitancy
enuresis
change in urine color
prostatitis
epididymitis
scrotal problems
TURP
pain on intercourse
genital lesions
genital discharge

REVIEW_OF_SYSTEMS_3
OB/GYN
metorrhagia
menorrhagia
irregular menses
problems in pregnancy
use of contraception
breast masses
nipple discharge
breast skin changes
changes in axillary nodes
monthly breast exam
breast feeding children
EXTREMITIES
difficulty with gait
weakness
joint swelling
joint stiffness
muscle pain
muscle swelling
muscle injuries
sagittal plan scoliosis
coronal plane scoliosis
fractured bones
SLE
osteoarthritis
rheumatoid arthritis
fibromyalgia
NEURO
seizures
head injury
LOC
loss of coordination
difficulty in balance
sciatica
difficulty in fine motor skills
difficulty speaking
CVA (stroke)
weakness in arms
weakness in legs
tingling in legs and feet
tingling in arms
PSYCHIATRIC
depression
bipolar disorder
suicide attempts
psychiatric hospitalizations
personality disorders
ENDOCRINE
goiter
exophthalmos
dry skin
dry hair
intolerance to heat
intolerance to cold
changes in growth
sterility
impotence
decreased libido
LYMPHATIC AND HEMATOLOGICAL
lymphadenopathy
transfusion
anemia

PHYSICAL_EVAL_1
VITALS
BP
Pulse
Temp
GENERAL
oriented X
GLASGOW COMA SCALE
Verbal Response
  none - 1
  incomprehensible sounds/cries -  2
 appropriate words/verbal sounds - 3
  confused speech or words - 4
  oriented speech - 5
Eye Opening Response
  no eye opening - 1
  eyes open to pain - 2
  eyes open to speech - 3
  eyes open spontaneously
Motor Response
  none - 1
  abnormal extension to pain - 2
  abnormal flexion to pain - 3
  withdraws to pain - 4
  localization to pain - 5
SKIN
dry
clammy
rash
cyanosis
jaundice
spider angiomata
spider hemorrhage
palmar erythema
petechia
localized fat atrophy
HEENT
skull tenderness
hematoma
lacerations
lacerations
PERRLA
EOMI
corneal reflex
Raccoon sign 
   (periorbital ecchymosis)
hemotypanum
tongue laceration
cheek laceration
pallor
atrophic tongue

PHYSICAL_EVAL_2
NECK
neck rigidity
carotid pulse amplitude
carotid pulse duration
carotid bruits
thyroid enlargement
lymphadenopathy
CHEST
Cheyne-Stokes breathing pattern
hyperventilation
barrel chest
rhonchi
fine crackles
course crackles
wheezes
HEART
regular rate & rhythm
S3 gallop
rubs
murmurs
ABDOMEN
tenderness
distention
dilated superficial veins
masses
ascites
hepatomegaly
RECTAL
guaiac (occult blood)
EXTREMITIES
track marks
sclerotic veins
NEURO
SKIN
dry
clammy
rash
cyanosis
jaundice
spider angiomata
spider hemorrhage
palmar erythema
petechia
localized fat atrophy


DIFF_DIAGNOSIS
Electrolyte imbalance
hyperglycemia
hypoglycemia/insulin overdose
alcohol/drug treatment
arrhythmia
hypoxia
hypercapnia
anemia
meningitis
encephalitis
systemic infection
cerebrovascular dz.
intracranial hemorrhage
thrombophlebitis
exacerbation of dementia
narcotic overdose
anticholinergic overdose
analgesic overdose
sedative overdose
antiarrhythmic overdose
steroid withdrawal
hypotension
hepatic encephalopathy
psychotic states
dehydration
hypertensive encephalopathy
head trauma
subdural hematoma
vitamin deficiency
malnutrition
uremia
hypo/hyperthyroidism
adrenal failure
ketoacidosis
acidosis
alkalosis
factitious coma


